Nursing Home Association Seeks Extension of Public Health Emergency | Healthcare Innovation

An association representing more than 14,000 nursing homes and assisted living communities is urging the U.S. Department of Health and Human Services (HHS) to extend the Public Health Emergency to ensure long-term care facilities have the resources to continue providing quality care.

In a letter to HHS Secretary Xavier Becerra, Mark Parkinson, president and CEO of the American Health Care Association and National Center for Assisted Living (AHCA/NCAL), urged HHS to extend the PHE beyond its current Oct. 13, 2022, expiration, and as the pandemic continues to evolve, AHCA/NCAL asked that HHS update its COVID-19 guidance for healthcare settings.

Parkinson noted that the prevalence of COVID-19 in the broader community has an impact on long-term care residents and staff. “As we head into influenza season this fall, we need to ensure our healthcare infrastructure can quickly adapt, especially should a future variant elude the protection of our vaccines. Extending the PHE is critical to ensure states and healthcare providers, including long-term care providers, have the flexibilities and resources necessary to respond to this ever-evolving pandemic.”

Specifically, AHCA/NCAL is requesting that HHS extend the PHE declaration and maintain the related Section 1135 and Section 1812(f) waivers, enhanced Medicaid FMAP to states, and state Medicaid policy flexibilities, such as the waiver for Medicaid redeterminations. “We also ask for the reinstatement of the 1135 waiver on training and certification of nurse aides in order to support retaining temporary nurse aides who have been a valuable member of the care team during this pandemic,” Parkinson wrote. “Given that your agency has committed to a 60-day notice to states and stakeholders when the PHE will expire, we hope that HHS will indicate by August 12 that the PHE will be renewed. Now is not the time to let crucial supports and flexibilities necessary to combat and recover from the virus end.”

AHCA/NCAL also would like HHS to evolve its COVID guidance for healthcare settings, including long-term care facilities. 

Parkinson noted that for six months running, the rate of COVID-19 deaths among nursing home residents has been less than 1 per 1,000 residents. This is in large part due to the significant vaccine uptake among nursing home residents—nearly 85 percent have received at least one booster dose, higher than percentage of Americans over the age of 65 who have done the same (70 percent).

“Despite the progress we have made, nursing homes still must follow extremely stringent COVID-19 protocols in the areas of masking and personal protective equipment (PPE), testing, reporting, visitor screening, and isolation periods—or face harsh penalties. Meanwhile, there are concerning reports that other healthcare settings are held to different standards with little to no consequences for failing to adhere to COVID protocols, even though the Centers for Disease Control and Prevention (CDC) guidance is applicable to all healthcare settings.”

AHCA/NCAL stressed that long-term caregivers are exhausted and burned out after fighting this virus for more than two years—to the point where many have left the profession altogether. “Nursing homes have been experiencing a historic labor crisis, disproportionally losing more workers than any other health care sector during this pandemic and grappling with workforce levels not seen in nearly 30 years,” the letter said. “There are many factors contributing to this labor crisis, one of which being these COVID protocols. Nursing homes are finding it difficult to recruit and retain staff when caregivers can find work in other health care settings or businesses that have less stringent COVID protocols.”